Healthcare Provider Details

I. General information

NPI: 1609824374
Provider Name (Legal Business Name): JUANITA M MURAWSKI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 12/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 UPHAM DR
COLUMBUS OH
43210-1250
US

IV. Provider business mailing address

660 ACKERMAN RD PO BOX 183103
COLUMBUS OH
43202-4500
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-9600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35047796
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: